Active NPI
Catherine Ann Bobenrieth, M.D
- Psychiatry Physician
- Jacksonville Beach, FL
National Provider Identifier
1508843517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME124747
- Practice address
- 1538 The Greens Way
Suite 101
Jacksonville Beach, FL 32250 - Phone
- (904) 543-0161
- Fax
- (904) 543-9172
- NPI assigned
- Dec 30, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 98-15 | NM | |
| Psychiatry Physician | 2084P0800X | ME124747 | FL | Primary |
Addresses
Primary practice location
1538 The Greens Way
Suite 101
Jacksonville Beach, FL 32250
Mailing address
1538 The Greens Way
Suite 101
Jacksonville Beach, FL 32250
Phone (904) 543-0161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98-15 | NM | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marsh Landing Behavioral Group Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Jacksonville Beach, FL
- NPI 1124143490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1508843517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1538 THE GREENS WAY",
"address_2": "SUITE 101",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "32250",
"telephone_number": "904-543-0161",
"fax_number": "904-543-9172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1538 THE GREENS WAY",
"address_2": "SUITE 101",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "32250",
"telephone_number": "904-543-0161",
"fax_number": "904-543-9172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBENRIETH",
"first_name": "CATHERINE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-30",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NM",
"license": "98-15",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME124747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.